Wisconsin School of Professional Psychology

Primary specialty

PsychologistTaxonomy code 103T00000X

License

2001 Issued in WI

Legal business name

WISCONSIN SCHOOL OF PROFESSIONAL PSYCHOLOGY

Doing business as

WSPP Psychology Center

Practice address

9120 W Hampton Ave
Suite 90
Milwaukee, WI 53225-4960

Phone

(414) 466-9777

Fax

(414) 358-5590

NPI assigned

May 11, 2007

Last updated

Jun 17, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Susan Ann Dvorak, PH.D.NPI 1144438672

Title

Director of Clinical Training

Phone

(414) 466-9777

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• WSPP Psychology Center Doing business as

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Susan Dvorak, PH.D.

  • Psychologist
  • Milwaukee, WI
  • NPI 1144438672
  NPD (past) Authorized official
• Sheryl L Dolezal, PSYD

  • Clinical Psychologist
  • Milwaukee, WI
  • NPI 1497839872
  NPD (past)
• Kimberly Sylvia Klages, PSY.D., LP

  • Psychologist
  • Beaumont, TX
  • NPI 1679133367
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213660800000",
    "number": "1902011257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9120 W HAMPTON AVE",
            "address_2": "SUITE 90",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532254960",
            "telephone_number": "414-466-9777",
            "fax_number": "414-358-5590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9120 W HAMPTON AVE",
            "address_2": "SUITE 90",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532254960",
            "telephone_number": "414-466-9777",
            "fax_number": "414-358-5590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISCONSIN SCHOOL OF PROFESSIONAL PSYCHOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-11",
        "last_updated": "2008-06-17",
        "status": "A",
        "authorized_official_last_name": "DVORAK",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "DIRECTOR OF CLINICAL TRAINING",
        "authorized_official_telephone_number": "414-466-9777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "WI",
            "license": "2001",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "2001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42182700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WSPP Psychology Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Wisconsin Nurturing & Family Services LLC
• Wisconsin Outreach for Mothers and Babies LLC (Womb LLC)
• Wisconsin Renal Care Group, L.L.C. (Fresenius Kidney Care Shorewood)
• Wisconsin Renal Care Group, L.L.C. (WRCG Milwaukee)
• Wisconsin Retina, S.C.
• Wisconsin Smiles (American Dental Group)
• Wisconsin Special Security Services LLC
• Wisconsin Stress Control Center, LTD
• Wisconsin Surgery Center LLC
• Wisconsin Telehealthcare Network

• Psychologist in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.